Liprazide 20, 30 tablets — Made in Ukraine — Free Delivery

Name: Liprazide 20, 30 tablets — Made in Ukraine — Free Delivery
Brand: Borshchahivskiy CPP
Price: 19.5685 USD
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Brand: Borshchahivskiy CPP
Product Code: Liprazide 20
Availability: In Stock

$19.57

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Description

Pharmacological properties

Pharmacodynamics. Liprazide is a combined antihypertensive preparation containing the APF inhibitor lisinopril and the diuretic hydrochlorothiazide.

Lisinopril inhibits ACE, which converts angiotensin I to angiotensin II. A decrease in the content of angiotensin II leads to a direct decrease in the level of aldosterone. This causes a decrease in TPVR and systemic blood pressure.

Hydrochlorothiazide is a thiazide diuretic with an antihypertensive effect. Reduces the reabsorption of electrolytes and water in the distal tubules of the kidneys, increases urine output, as a result of which the BCC decreases and the increased blood pressure decreases. A significant decrease in systolic and diastolic blood pressure is noted after 3-4 days of taking hydrochlorothiazide, and the optimal antihypertensive effect - after 3-4 weeks of taking the preparation.

The combination of lisinopril and hydrochlorothiazide has a more pronounced hypotensive effect than each component alone.

Pharmacokinetics. The bioavailability of lisinopril is about 30%. Food intake does not significantly affect the absorption of lisinopril. A small amount (6-10%) binds to blood plasma proteins. The initial effect after taking lisinopril develops after 1 hour, Cmax in blood plasma is achieved 6-7 hours after administration. Virtually no biotransformed in the body, only about 7% of lisinopril is metabolized in the liver. Lisinopril partially crosses the placental barrier. The main amount of the substance is excreted from the body unchanged in the urine. T½ is 12 hours. Elimination of lisinopril in elderly patients is slowed down.

The diuretic effect of hydrochlorothiazide develops 2 hours after administration and reaches its maximum severity after 3-4 hours, lasts 6-12 hours. The bioavailability of hydrochlorothiazide is 65-70%. About 40% binds to blood plasma proteins. It crosses the placenta and is excreted in breast milk. Hydrochlorothiazide is not metabolized, excreted by the kidneys.

Indications

Ag, if the desired decrease in blood pressure is not achieved by monotherapy with hydrochlorothiazide or lisinopril.

Application

The preparation is prescribed taking into account the doses of lisinopril or hydrochlorothiazide, which were used in monotherapy. the dose is selected individually depending on the therapeutic effect.

The recommended initial dose (in terms of lisinopril) is 5-10 mg / day, further the dose is adjusted taking into account the achieved clinical effect.

The recommended maintenance dose is 20 mg once a day. The maximum daily dose (in terms of lisinopril) is 40 mg.

A stable therapeutic effect usually develops after 2-4 weeks of taking the preparation.

In patients with creatinine clearance of 30 and 80 ml / min, only Liprazide 10 can be used.

If it is necessary to use the preparation in a dose of 2.5 and 5 mg, dosage forms with the possibility of such dosage should be used.

Contraindications

Hypersensitivity to lisinopril, hydrochlorothiazide or other components of the preparation; hypersensitivity to sulfonamide derivatives; a history of hereditary or idiopathic angioedema (angioedema); a history of angioedema caused by taking APF inhibitors;

bilateral renal artery stenosis or renal artery stenosis of a solitary kidney; mitral or aortic stenosis, hypertrophic cardiomyopathy with severe hemodynamic disorders; acute myocardial infarction with unstable hemodynamics; cardiogenic shock; severe renal (creatinine clearance 30 ml / min) and hepatic impairment; condition after kidney transplantation; mechanical obstruction of the urinary tract; hemodialysis using high-strength membranes; disorders of water-salt metabolism (hyperkalemia / hypokalemia, hyponatremia, hypovolemia); severe forms of diabetes mellitus; severe hepatic impairment, hepatic encephalopathy; primary hyperaldosteronism; exacerbation of gout; porphyria; anuria.

Side effects

On the part of the cardiovascular system: arterial hypotension (including orthostatic hypotension), myocardial infarction or secondary cerebrovascular disorders (stroke) as a result of a significant decrease in blood pressure, syncope, palpitation, tachycardia, bradycardia, angina pectoris, atrioventricular conduction disorder in the chest and pain , Raynaud's syndrome, necrotizing vasculitis.

From the side of the central nervous system: headache, dizziness, imbalance, disorientation in space, loss of consciousness, mood lability, symptoms of depression, change in taste and impaired taste sensations, decreased or loss of appetite, impaired sense of smell, anorexia, impaired concentration, decreased thinking, apathy, increased fatigue, paresthesias, vertigo, general weakness, cramps of the limbs and twitching of the lips, rarely asthenic syndrome, confusion, agitation, anxiety, irritability, depression, sleep disturbances, including insomnia, and other mental changes.

From the gastrointestinal tract: decreased appetite, dry mouth, increased thirst, heartburn, nausea, vomiting, sialorrhea, dyspepsia, abdominal pain / cramps, constipation, diarrhea, dyspepsia, stomatitis / aphthous ulcers, glossitis, sialadenitis, intestinal angioedema, cholecystitis pancreatitis, hepatitis, including hepatocellular or cholestatic; jaundice, liver failure, development of hepatic encephalopathy or hepatic coma.

From the respiratory system: dry cough, respiratory rhythm disturbance, dyspnea, bronchospasm, bronchitis, rhinitis, sinusitis, allergic alveolar / eosinophilic pneumonia, respiratory distress syndrome, including pneumonia and pulmonary edema. Upper respiratory tract infections have been recorded.

On the part of the skin: increased sweating, skin flushing, hair loss, dermatological manifestations, including psoriasis, pemphigoid reactions, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, photosensitivity reactions, eczema, complex skin reactions (may be accompanied by itching, fever, myalgia, arthralgia, vasculitis, positive test for antinuclear antibodies, increased ESR, eosinophilia, leukocytosis, rashes), purpura, exfoliative dermatitis, exacerbation of systemic lupus erythematosus, cutaneous pseudolymphoma.

From the blood and lymphatic system: anemia, including hemolytic, aplastic, decreased hemoglobin, hematocrit, erythrocytopenia, leukopenia / leukocytosis, thrombocytopenia, neutropenia, agranulocytosis, purpura, lymphadenopathy, myelosuppression.

From the urinary system: impaired renal function, in some cases - acute renal failure, uremia, polyuria, oliguria / anuria; glucosuria, interstitial nephritis.

From the reproductive system and mammary glands: decreased potency / impotence, gynecomastia.

From the immune system: hypersensitivity reactions, including anaphylactic reactions (anaphylactic shock), autoimmune diseases.

Allergic reactions: difficulty in swallowing and breathing, angioedema (lips, face, eyes, mouth, tongue, epiglottis and / or larynx, extremities), itching, urticaria.

Changes in laboratory parameters: very rarely - electrolyte imbalance (hypokalemia, hypomagnesemia, hyponatremia, hypochloremia, hypercalcemia), hyperglycemia, hyperuricemia, hyperkalemia, increased levels of urea and creatinine, hypercholesterolemia, hypertriglyceridemia, hyperbilirubinemia, decreased hepatic kinase activity, decreased hepaticinemia glucose, increased levels of cholesterol and triglycerides in blood plasma, positive test for antinuclear antibodies, increased ESR.

Others: fever, arthritis, gout, muscle spasm or muscle pain, short-term decrease in visual acuity, xanthopsia, conjunctivitis, impaired antidiuretic hormone secretion, hyperchloremic alkalosis, diabetes mellitus, tinnitus, ear pain.

Special instructions

Arterial hypotension and water-electrolyte imbalance. in patients with dehydration and electrolyte imbalance due to diuretic treatment, which was carried out earlier or with dehydration of a different genesis (increased sweating, prolonged vomiting, profuse diarrhea) after taking liprazide, symptomatic arterial hypotension may occur. to prevent it, the use of diuretics should be discontinued 2-3 days before starting treatment with liprazide.

Patients with an increased risk of symptomatic hypotension should begin treatment under medical supervision and with periodic monitoring of plasma electrolyte levels.

With arterial hypotension, the patient should be in the supine position, if necessary, intravenous physiological solution should be injected. A transient antihypertensive reaction is not a contraindication to further treatment. To further restore the effective blood volume and blood pressure, it is necessary to reduce the dose or switch to monotherapy with one of the active components of the preparation. When changing the dose, control should be especially careful.

Aortic stenosis / hypertrophic cardiomyopathy. ACE inhibitors should be used with caution in patients with left ventricular outflow tract obstruction. It is prescribed with caution in patients with coronary artery disease or cerebrovascular disease, since a pronounced decrease in blood pressure can cause myocardial infarction or cerebrovascular stroke.

Surgery / general anesthesia. Caution should be exercised when using Liprazide in patients who are planning to undergo surgery under anesthesia, since with major surgical interventions and the use of other preparations that cause a decrease in blood pressure, lisinopril, blocking the formation of angiotensin II, can cause a pronounced unpredictable decrease in blood pressure. Hypotension of this genesis can be eliminated by compensation of the intravascular fluid.

Metabolic and endocrine effects. Thiazide therapy can reduce glucose tolerance. Dose adjustment of antidiabetic agents, including insulin, may be required. Thiazides can reduce the excretion of calcium in the urine and cause an unstable and slight increase in the level of calcium in the blood plasma. Hypercalcemia may indicate latent hyperparathyroidism. Thiazides must be discontinued before performing functional tests of the parathyroid glands. An increase in the level of cholesterol and triglycerides may be associated with thiazide diuretic therapy. Thiazide diuretic therapy may precipitate hyperuricemia and / or gout in some patients. However, lisinopril can increase the excretion of uric acid and thus reduce the hyperuricemic effect of hydrochlorothiazide.

Patients with diabetes mellitus. In patients with diabetes mellitus taking oral antidiabetic preparations or insulin, it is necessary to carry out careful glycemic control, especially in the first month of therapy with ACE inhibitors. The manifestation of latent diabetes is possible.

Hypersensitivity / angioedema. Angioedema of the face, upper and lower extremities, lips, tongue, epiglottis and / or larynx has rarely been reported in patients taking ACE inhibitors, including lisinopril. This can happen at any time, in such cases, the use of Liprazide should be stopped immediately and appropriate control should be prescribed until the symptoms disappear completely.

Fatalities due to angioedema of the larynx or tongue have been reported very rarely. If the swelling extends to the tongue, vocal cords, or larynx, airway obstruction may occur, especially in patients who have previously undergone respiratory surgery. In such cases, it is necessary to take emergency measures (administration of adrenaline (epinephrine) and / or maintenance of airway patency). The patient should be under medical supervision until the symptoms disappear completely and sustainably. Patients with a history of angioedema not associated with therapy with an ACE inhibitor may be at risk of developing angioedema while receiving an ACE inhibitor. In patients on thiazide therapy, hypersensitivity reactions may occur (with or without a history of allergies or bronchial asthma). Against the background of the use of the preparation, an exacerbation of the course of connective tissue diseases, including systemic lupus erythematosus, is possible.

Anaphylactoid reactions in LDL apheresis. Rarely, life-threatening anaphylactoid reactions have developed in patients treated with ACE inhibitors during LDL apheresis using dextran sulfate absorption. To avoid these reactions, ACE inhibitors should be stopped before each apheresis procedure.

Anaphylactoid reactions during desensitizing therapy. Anaphylactoid reactions developed in patients who received ACE inhibitors during desensitization with an allergen from hymenoptera venom (eg bee venom). If such patients refrained from taking ACE inhibitors during desensitization, no reactions were detected, however, accidental administration of ACE inhibitors provoked anaphylactoid reactions.

Cough. Characterized by a non-productive / persistent cough, noted with ACE inhibitors and disappearing after discontinuation of therapy. ACE inhibitor cough should be differentiated from cough associated with other conditions.

Salt-free diet. Care should be taken to prescribe the preparation to patients on a salt-free diet.

Impaired renal function. Thiazides may be inadequate diuretics for use in patients with renal impairment, and they are also ineffective with creatinine clearance ≤30 ml / min (moderate to severe renal impairment). Liprazide should not be prescribed to patients with renal insufficiency (creatinine clearance 80 ml / min), unless an acceptable dose is achieved by titration of doses of individual active substances of the preparation, which is present in the combination.

In some patients with hypertension without obvious signs of damage to the blood vessels of the kidneys, a slight temporary increase in the level of urea and creatinine in the blood plasma is possible, especially when lisinopril was used simultaneously with diuretics. This is more common in patients with pre-existing renal impairment. This condition requires dose reduction and / or discontinuation of the diuretic and / or Liprazide.

Patients on hemodialysis. With the simultaneous use of lisinopril and hemodialysis with high-throughput membranes (polyacrylonitrile), anaphylactic reactions (swelling of the tongue and lips, shortness of breath, arterial hypotension) are possible. The preparation is contraindicated for the treatment of patients on hemodialysis. It is also not prescribed for patients with a transplanted kidney.

Liver disease. Thiazides should be used with caution in patients with impaired function or progressive liver disease, since minor changes in water-salt and electrolyte balance can cause sudden hepatic coma.

Very rarely, with the use of ACE inhibitors, a syndrome is associated that begins with cholestatic jaundice or hepatitis and progresses to liver necrosis, sometimes with a fatal outcome. The mechanism of this syndrome is unknown. If patients taking ACE inhibitors develop jaundice or significantly increase the activity of liver enzymes, the preparation should be discontinued, and the patient should be under medical supervision until the symptoms disappear.

Elderly persons. Treatment begins with the lower dose limit of Liprazide (10 mg + 12.5 mg) due to the fact that the likelihood of deterioration in liver, kidney and heart function is higher due to concomitant diseases and the use of other preparations . When choosing a dose, you should observe safety measures (control of renal function).

Neutropenia / agranulocytosis. Patients taking ACE inhibitors may develop neutropenia / agranulocytosis, thrombocytopenia, and anemia. With normal renal function and no complications, neutropenia is rare. Neutropenia and agranulocytosis are reversible and disappear after discontinuation of ACE inhibitors.

Liprazide should be used with extreme caution in patients with connective tissue disease with vascular manifestations, during treatment with immunosuppressants, allopurinol or procainamide, and also with a combination of these factors, especially in the presence of pre-existing renal dysfunction.

Some of these patients develop severe infections that sometimes do not respond to intensive antibiotic therapy. When using Liprazide in this group of patients, it is recommended to carry out periodic monitoring of leukocytes, and the patient should also be warned about the need to inform the doctor about any signs of infection.

Hyperkalemia. In some patients, when taking ACE inhibitors, including lisinopril, an increase in the concentration of potassium in the blood plasma was noted. Risk factors for hyperkalemia include renal failure or diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium-containing dietary supplements or potassium salt substitutes, or other preparations that increase plasma potassium levels (such as heparin). If taking the above preparations while being treated with ACE inhibitors is considered necessary, regular monitoring of the level of potassium in the blood plasma is recommended.

Lithium. Concomitant use of lithium and lisinopril is generally not recommended.

Ethnic characteristics. Representatives of the Negroid race who took ACE inhibitors had more angioedema than patients of other races. As with other ACE inhibitors, the antihypertensive effect of lisinopril is less pronounced in patients of the Negroid race than in patients of a different race, which may be due to the low level of renin in the blood of these patients.

The hypotensive effect of hydrochlorothiazide may increase after sympathectomy.

The preparation can affect laboratory parameters: due to the effect on calcium metabolism, thiazide derivatives can change the results of a test to determine the function of the parathyroid glands.

Against the background of the use of hydrochlorothiazide, false-positive results of anti-doping control are possible.

For the period of treatment with Liprazide, exposure to the sun should be limited (risk of developing photosensitivity).

During the period of treatment with Liprazide, alcohol is not recommended.

Use during pregnancy and lactation. The use of the preparation during pregnancy is contraindicated, since hydrochlorothiazide reduces the plasma volume in the mother, the uteroplacental blood supply and penetrates the placental barrier. There is a risk of fetal or neonatal jaundice, thrombocytopenia and other harmful effects in the fetus.

If pregnancy is established, the use of the preparation should be suspended.

The condition of newborns whose mothers took ACE inhibitors should be carefully monitored due to the possibility of arterial hypotension, oliguria and hyperkalemia in such newborns.

If it is necessary to use the preparation in women who are breastfeeding, it is recommended to stop feeding.

Children. Contraindicated.

The ability to influence the reaction rate when driving or operating machinery. Due to the risk of side reactions such as dizziness (especially at the beginning of treatment), confusion, arterial hypotension, it is not recommended to drive vehicles or work with other mechanisms until the individual patient's response to the preparation is determined.

Interactions

Lisinopril with:

NSAIDs, including acetylsalicylic acid at a dose of ≥3 g / day: a decrease in the severity of the antihypertensive effect, hyperkalemia and deterioration of renal function. As a rule, this action is reversible. Occasionally, acute renal failure is possible, especially in patients with reduced renal function (elderly people, with dehydration);
lithium preparations: the level of lithium in the blood plasma increases reversibly and toxic effects develop. The use of thiazide diuretics may increase the risk of lithium intoxication and exacerbate it if it is already caused by the concomitant use of ACE inhibitors. It is not recommended to use lisinopril simultaneously with lithium, but if such a combination is necessary, careful monitoring of the lithium level in the blood plasma should be carried out;

allopurinol: the risk of kidney damage and the development of leukopenia increases;
cyclosporine, heparin, trimethoprim: the risk of impaired renal function and the development of hyperkalemia increases;
lovastatin: concomitant use increases the risk of hyperkalemia;
cytostatics, immunosuppressants, procainamide: simultaneous administration with ACE inhibitors increases the risk of leukopenia;
tricyclic antidepressants, antipsychotic and pain relievers (anesthetics): may increase hypotension;
sympathomimetic agents: it is possible to reduce the severity of the hypotensive effect of ACE inhibitors;
antidiabetic agents (oral hypoglycemic agents and insulin): a decrease in blood glucose levels with a simultaneously increasing risk of hypoglycemia (the likelihood of this phenomenon is higher during the first 2 weeks of combination therapy in patients with weakened renal function);
diuretics: there is a summation of the antihypertensive effect. In patients taking diuretics, especially in those who have recently been prescribed diuretics, the use of lisinopril can sometimes cause an excessive decrease in blood pressure. The risk of developing symptomatic arterial hypotension can be reduced if the diuretic is discontinued before starting treatment with lisinopril;
potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium preparations or salt substitutes containing potassium: the risk of hyperkalemia increases.
The risk of hyperkalemia is associated with factors that include renal failure, diabetes mellitus, concomitant use of potassium-sparing diuretics and potassium-containing dietary supplements or salt substitutes.
When lisinopril is used against the background of potassium-excreting diuretics, the severity of hypokalemia caused by their intake can be reduced;
loop diuretics (ethacrynic acid, furosemide): can lead to the development of arterial hypotension of varying severity;
antacids: the bioavailability of lisinopril may decrease;
estrogens, GCS: a decrease in the severity of the antihypertensive effect of Liprazide is possible;
aldesleukin: enhancement of the hypotensive effect of Liprazide;
gold preparations: nitritoid reactions (symptoms of vasodilation, including hot flashes, nausea, dizziness, arterial hypotension, which can be very severe) after an injection of gold (for example sodium aurothiomalate) were observed more often in patients treated with ACE inhibitors;
Lisinopril can be administered concurrently with acetylsalicylic acid (in doses used in cardiology), thrombolytics, β-adrenergic receptor blockers and / or nitrates.

Alcohol potentiates the hypotensive effect of ACE inhibitors.

Hydrochlorothiazide with:

cardiac glycosides: the likelihood of toxic effects of glycosides (including increased excitability of the ventricles) increases due to the development of thiazide-induced hypokalemia and hypomagnesemia;
non-depolarizing muscle relaxants: enhances the effect of the latter and increases sensitivity to tubocurarine;

preparations that cause changes in the level of potassium in the blood plasma: an increased risk of developing cardiac arrhythmias, including ventricular tachycardia (for example, torsades de pointes):

class I antiarrhythmic preparations (quinidine, hydroquinidine, disopyramide);
class III antiarrhythmic preparations (amiodarone, sotalol, dofetilide, ibutilide);
antipsychotics (for example, thioridazine, chlorpromazine, levomepromazine, trifluoperazine, sulpiride, amisulpiride, pimozide, haloperidol, droperidol);
others (eg bepridil, cisapride, diphemanil, erythromycin, pentamidine, terfenadine, vincamine);
anti-inflammatory preparations (especially indomethacin): the antihypertensive, diuretic and natriuretic effect of thiazides decreases, the risk of NSAID-induced renal dysfunction increases;
difluzanil: the concentration of hydrochlorothiazide in the blood plasma increases and the severity of its hyperuricemic action decreases;
ethanol, barbiturates (for example phenobarbital), diazepam, narcotic analgesics, antidepressants: may enhance the hypotensive effect of hydrochlorothiazide;
norepinephrine, pressor amines: hydrochlorothiazide reduces their effect on blood pressure;
lithium salts: simultaneous use with hydrochlorothiazide should be avoided through the possibility of increasing the concentration of lithium salts in the blood plasma to a toxic level;
antidiabetic preparations (oral preparations , insulin): may cause a decrease in blood glucose levels with a risk of hypoglycemia;
metformin: should be used with caution because of the risk of lactic acidosis induced by possible functional renal failure associated with hydrochlorothiazide;
cholestyramine and colestipol resins: the absorption of hydrochlorothiazide is reduced in the presence of anionic resins up to 85%;
other antihypertensive preparations: additive effect;
probenecid, sulfinpyrazone and allopurinol: dose adjustment of uricosuric preparations is necessary, since hydrochlorothiazide can increase the level of uric acid in the blood plasma. Increasing the dose of probenecid or sulfinpyrazone may be required. Concomitant use of thiazide diuretics, including hydrochlorothiazide, may increase the frequency of hypersensitivity reactions to allopurinol;
cytotoxic preparations (for example, cyclophosphamide, methotrexate): thiazides can reduce renal excretion of cytotoxic preparations and enhance their myelosuppressive effects;
anticholinergics (eg atropine, biperiden): increase the bioavailability of thiazide diuretics, decreasing gastrointestinal motility and gastric emptying rate;
salicylates: at high doses of salicylates, hydrochlorothiazide may increase their toxic effect on the central nervous system;
methyldopa: isolated cases of hemolytic anemia have been reported with simultaneous use with hydrochlorothiazide;
cyclosporine: increased risk of hyperuricemia and gout;

amphotericin B (parenteral), laxatives, intestinal motility stimulants, GCS, adrenocorticotropic hormone / calcitonin: hydrochlorothiazide may increase electrolyte imbalance, especially hypokalemia;
β-adrenergic receptor blockers and diazoxide: an increase in the severity of their hyperglycemic effect due to thiazides is possible;
calcium salts and vitamin D: thiazide diuretics reduce calcium excretion and may increase plasma calcium levels. Plasma calcium levels should be monitored and the calcium / vitamin D dose adjusted;
amantadine: hydrochlorothiazide may increase the risk of side reactions to amantadine;
carbamazepine: development of hyponatremia. It is necessary to control the level of electrolytes, if necessary, use diuretics of other groups;
trimethoprim: concomitant use with ACE inhibitors and thiazide diuretics increases the risk of hyperkalemia;
sympathomimetics: it is possible to reduce the severity of the hypotensive effect;
sotalol: with simultaneous use, the risk of arrhythmia increases;
preparations containing concentrated iodine: with dehydration induced by diuretics, the risk of developing acute renal failure increases, especially against the background of high doses of iodine. It is necessary to rehydrate before use;
activated carbon, tetracyclines: absorption of hydrochlorothiazide decreases.

Hydrochlorothiazide increases the toxicity of digoxin.

There is a risk of a dangerous interaction of hydrochlorothiazide with quinidine when, due to hydrochlorothiazide-induced hypokalemia, the risk of ventricular fibrillation increases;

pressor amines (for example, epinephrine (adrenaline): the reactions of pressor amines decrease, but not enough to exclude their use.

The use of thiazides should be discontinued before conducting a study of the function of the parathyroid glands.

Overdose

Symptoms: acute arterial hypotension, headache, drowsiness, dizziness, anxiety, fatigue, weakness, impaired consciousness, dry mouth, cough, thirst, nausea, vomiting, hyperventilation, tachycardia, bradycardia, heart rhythm disturbances, cardiovascular shock, spasms / cramps of the calf muscles, paresthesias, disturbances in water-electrolyte balance and acid-base balance (dehydration, hypokalemia, hyponatremia, hypochloremia, alkalosis), increased levels of urea nitrogen in the blood (especially in patients with renal failure), opn.

Treatment: symptomatic and supportive therapy, there is no specific antidote. Gastric lavage is advisable if no more than 4 hours have passed after taking the preparation. If necessary, provide oxygen or artificial respiration. It is shown that the correction of the water-electrolyte balance is carried out with the control of laboratory parameters of renal function until their normalization.

In case of hypotension, the patient is transferred to a supine position with raised lower extremities, an intravenous infusion of isotonic sodium chloride solution is carried out. Lisinopril is excreted during hemodialysis, however, the use of high-flow polyacrylonitrile membranes for dialysis and hemofiltration should be avoided due to the risk of anaphylactic reactions. For the treatment of persistent bradycardia, the use of a pacemaker is indicated.

In case of development of angioedema, 0.3–0.5 ml of epinephrine solution should be injected subcutaneously, and desensitizing agents should be prescribed. Severe cases of angioedema of the tongue, glottis, and pharynx may require maintaining an upper airway (intubation, tracheotomy).

Storage conditions

At a temperature not higher than 25 ° C.

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